gms | German Medical Science

Background: Inguinal hernia (IH) is predominant in boys and preterm infants, but until today there has never been a systematic evaluation of gender-related differences. Since decades, contralateral groin exploration is a controversy. In the literature, age, sex, history of prematurity and initial side of clinical presentation have been reported as risk factors for the development of a metachronous inguinal hernia (MIH). The aim of this study was to analyse the gender-related differences of IH and patent processus vaginalis (PPV) in term and preterm infants.

Materials and methods: Over a nine-year-period 411 infants underwent laparoscopic hernia repair within the first six months of life. 246 term (191 male and 55 female) and 165 preterm (118 male and 47 female) infants were included in this retrospective study. Initial presentation of IH and intraoperative anatomical findings of PPV were reviewed in four groups of patients: term male, term female, preterm male and preterm female infants.

Results: We found that term boys (58.6 %) and girls (58.2 %) predominantly presented with right-sided IH whereas preterm boys (36.4 %) and girls (44.7 %) mostly presented with bilateral IH. Female babies had a higher incidence of initial left-sided IH compared with male babies. Term and preterm girls with initial left-sided hernia were found to have highest incidence of PPV (77.8 % and 83.3 %). Male term babies with initial left-sided IH were found to have the lowest incidence of PPV (25.0%). The highest incidence of PPV was found in preterm boys with either left- or right-sided IH (50.0 % and 48.5 %).

Conclusion: The incidence and laterality of IH and PPV differs between term and preterm girls and boys. In order to evaluate the risk for the development of MIH these results should be taken into account concerning the necessity of contralateral groin exploration.